Landolt Markus A, Vollrath Margarete, Ribi Karin, Gnehm Hanspeter E, Sennhauser Felix H
University Children's Hospital, Zurich, Switzerland.
J Child Psychol Psychiatry. 2003 Nov;44(8):1199-207. doi: 10.1111/1469-7610.00201.
Previous studies consistently found remarkable prevalence rates of posttraumatic stress symptoms (PTSS) and posttraumatic stress disorders (PTSD) in pediatric patients and their parents. Findings suggest a significant association between child and parent PTSS. The present study examined, in a sample of pediatric patients with different conditions, incidence rates and determinants of PTSS and PTSD in the patients, and their mothers and fathers. Also, associations of maternal, paternal and child PTSS and PTSD were analyzed.
Two hundred and nine children (aged 6.5-14.5 years) were interviewed 5-6 weeks after an accident or a new diagnosis of cancer or diabetes mellitus type 1 by means of the Child PTSD Reaction Index. Their mothers (n = 180) and fathers (n = 175) were assessed with the Posttraumatic Diagnostic Scale.
Children reported PTSS levels in the mild range. Sixteen percent of the fathers and 23.9% of the mothers met full DSM-IV diagnostic criteria for current PTSD. Type of trauma impacted differently on parents and children. In children, accident-related injury was associated with higher PTSS scores. Conversely, in parents, diagnosis of cancer in their child was associated with more symptoms. Functional status of the child was also found to be an important predictor of PTSS in children and parents. PTSS scores of mothers and fathers were significantly correlated with each other. However, child PTSS were not significantly related to PTSS of mothers and fathers. This was true for total scores as well as for DSM-IV symptom clusters.
There is a need for careful evaluation of PTSS and PTSD in pediatric patients with accidental injuries or sudden onset of severe chronic diseases and in their respective parents. Importantly, children, their mothers, and their fathers should be assessed separately, because a significant association between child and parental PTSS may not exist.
先前的研究一致发现，儿科患者及其父母中创伤后应激症状（PTSS）和创伤后应激障碍（PTSD）的患病率很高。研究结果表明儿童和父母的PTSS之间存在显著关联。本研究在患有不同疾病的儿科患者样本中，调查了患者及其父母中PTSS和PTSD的发病率及决定因素。此外，还分析了母亲、父亲和儿童的PTSS及PTSD之间的关联。
通过儿童创伤后应激反应指数，对209名儿童（年龄在6.5 - 14.5岁之间）在事故、新诊断出癌症或1型糖尿病后5 - 6周进行访谈。用创伤后诊断量表对他们的母亲（n = 180）和父亲（n = 175）进行评估。
儿童报告的PTSS水平处于轻度范围。16%的父亲和23.9%的母亲符合当前PTSD的完整DSM - IV诊断标准。创伤类型对父母和孩子的影响不同。在儿童中，与事故相关的损伤与较高的PTSS得分相关。相反，在父母中，孩子被诊断出癌症与更多症状相关。儿童的功能状态也是儿童和父母PTSS的重要预测因素。母亲和父亲的PTSS得分彼此显著相关。然而，儿童PTSS与母亲和父亲的PTSS没有显著关系。总分以及DSM - IV症状群都是如此。
对于遭受意外伤害或严重慢性疾病突然发作的儿科患者及其各自的父母，需要仔细评估PTSS和PTSD。重要的是，儿童、他们的母亲和父亲应分别进行评估，因为儿童和父母的PTSS之间可能不存在显著关联。
